Relationships among Stress, Experiential Avoidance and Depression in Psychiatric Patients

  1. Beatriz Rueda
  2. Esperanza Valls
Revista:
The Spanish Journal of Psychology

ISSN: 1138-7416

Año de publicación: 2016

Volumen: 19

Tipo: Artículo

DOI: 10.1017/SJP.2016.32 DIALNET GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: The Spanish Journal of Psychology

Resumen

This study investigated the specific association of stressful life events (SLE) and experiential avoidance (EA) with depression in patients with mental disorders. It also analyzed the possible mediating role of depression in the relation of EA to well-being and life satisfaction. A total of 147 patients (mean age = 40.16 years) diagnosed with anxiety, mood or adjustment disorder were recruited from a mental health centre. They completed measures of SLE, EA, depression, well-being and life satisfaction. Regression analyses showed that SLE and EA were positively related to depression (R2 = .45), although the contribution made by EA was higher (β = .61, p < .001) than the one made by SLE (β = .19, p < .01). Bootstrap mediation analyses revealed that there was an indirect effect from EA to physical well-being (B = –4.52, SE = .70, p < .001, 95% CI [–6.03, –3.20]) and satisfaction (B = –.14, SE = .02, p < .001, 95%, CI [–.19 –.09]) through depression. This indirect effect was less consistently supported with respect to emotional well-being (B = –3.33, SE = .48, p < .001, 95%, CI [–4.30, –2.41]). These findings give support to the hypothesis that EA could be an important factor contributing to depression in patients with mental disorders. The results also provide evidence that depression seems to play an important mediational role when considering the negative impact that EA exerts on patients´ well-being and satisfaction.

Referencias bibliográficas

  • Alonso J., Prieto L., & Anto J. M. (1995). La versión española del SF-36 Health Survey (Cuestionario de Salud SF-36): Un instrumento para la medida de los resultados clínicos [The Spanish version of the SF-36 Health Survey (the SF-36 health questionnaire): An instrument for measuring clinical results]. Medicina Clínica, 104, 771–776.
  • Anders S. L., Frazier P. A., & Shallcross S. L. (2012). Prevalence and effects of life event exposure among undergraduate and community college students. Journal of Counseling Psychology 59, 449–457. http://dx.doi. org/10.1037/a0027753
  • Beck A. T., Ward C. H., Mendelson M., Mock J., & Erbaugh J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571. http://dx.doi.org/10.1001/ archpsyc.1961.01710120031004
  • Bjornsson A., Carey G., Hauser M., Karris A., Kaufmann V., & Sheets E. (2010). The effects of experiential avoidance and rumination on depression among college students. International Journal of Cognitive Therapy, 3, 389–401. http://dx.doi.org/10.1521/ijct.2010.3.4.389
  • Bond F. W., Hayes S. C., Baer R. A., Carpenter K. M., Guenole N., Orcutt H. K., … Zettle R. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire – II: A revised measure of psychological flexibility and acceptance. Behaviour Therapy, 42, 676–688.
  • Cabañero M. J., Richart M., Cabrero J., Orts M. I., Reig A., & Tosal B. (2004). Fiabilidad y validez de la Escala de Satisfacción Vital de Diener en una muestra de mujeres embarazadas y puérperas [Reliability and validity of the Satisfaction with Life Scale of Diener in pregnant and puerperium women]. Psicothema, 16, 448–455.
  • Campbell-Sills L., Barlow D. H., Brown T. A., & Hofmann S. G. (2006). Effects of suppression and acceptance on emotional suppression of individuals with anxiety and mood disorders. Behaviour Research and Therapy, 44, 1251–1263. http://dx.doi.org/10.1016/j.brat.2005.10.001
  • Conde V., & Useros E. (1975). Adaptación castellana de la Escala de Evaluación Conductual para la Depresión de Beck [Spanish adaptation of Beck’s Depression Inventory]. Revista de Psiquiatría y Psicología Médica de Europa y América Latina, 12, 217–236.
  • Diener E., Emmons R. A., Larsen R. J., & Griffin S. (1985). The Satisfaction with Life Scale. Journal of Personality Assessment, 49, 71–75. http://dx.doi. org/10.1207/s15327752jpa4901_13
  • Eaton W. W., Regier D. A., Locke B. Z., & Taube C. A. (1981). The epidemiologic catchment area program of the National Institute of Mental Health. Public Health Reports, 96, 319–325.
  • Hayes S. C., Wilson K. G., Gifford E. V., Follette V. M., & Strosahl K. (1996). Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64, 1152–1168. http://dx.doi.org/10.1037/0022-006X. 64.6.1152
  • Hayes S. C., Luoma J. B., Bond F. W., Masuda A., & Lillis J. (2006). Acceptance and commitment therapy: Model, processes, and outcomes. Behaviour Research and Therapy, 44, 1–25. http://dx.doi.org/10.1016/j.brat.2005.06.006
  • Hofmann S. G., Heering S., Sawyer A. T., & Asnaani A. (2009). How to handle anxiety: The effects of reappraisal, acceptance, and suppression strategies on anxious arousal. Behaviour Research and Therapy, 47, 399–394. http://dx.doi. org/10.1016/j.brat.2009.02.010
  • Holmes T. H., & Rahe R. H. (1967). The Social Readjustment Rating Scale. Journal of Psychosomatic Research, 11, 213–218. http://dx.doi.org/10.1016/0022-3999(67)90010-4
  • Kashdan T. B., Barrios V., Forsyth J. P., & Steger M. F. (2006). Experiential avoidance as a generalized psychological vulnerability: Comparisons with coping and emotion regulation strategies. Behavior Research and Therapy, 44, 1301–1320. http://dx.doi.org/10.1016/ j.brat.2005.10.003
  • Kashdan T. B., Morina N., & Priebe S. (2009). Post-traumatic stress disorder, social anxiety disorder, and depression in survivors of the Kosovo War: Experiential avoidance as a contributor to distress and quality of life. Journal of Anxiety Disorders, 23, 185–196. http://dx.doi.org/10.1016/j. janxdis.2008.06.006
  • Kashdan T. B., Ferssizidis P., Collins R. L., & Muraven M. (2010). Emotion differentiation as resilience against excessive alcohol use: An ecological momentary assessment in underage social drinkers. Psychological Science, 21, 1341–1347. http://dx.doi.org/10.1177/0956797610379863
  • Keyes C. L. M. (2007). Promoting and protecting mental health as flourishing: A complementary strategy for improving national mental health. American Psychologist, 62, 95–108. http://dx.doi.org/10.1037/0003-066X.62.2.95
  • Kohl A., Rief W., & Glombiewski J. A. (2012). How effective are acceptance strategies? A meta-analytic review of experimental results. Journal of Behavior Therapy and Experimental Psychiatry, 43, 988–1001. http://dx.doi. org/10.1016/j.jbtep.2012.03.004
  • Linehan M. M. (2003) Manual de tratamiento de los trastornos de personalidad límite [Skills training manual for treating borderline personality disorder]. Barcelona, Spain: Paidós Ibérica.
  • Mitmansgruber H., Beck T. N., & Schüβler G. (2008). “Mindful helpers”: Experiential avoidance, meta-emotions, and emotion regulation in paramedics. Journal of Research in Personality, 42, 1358–1363.
  • Monroe S. M., Torres L. D., Guillaumot J., Harkness K., Roberts J., Frank E., … Kupfer D. (2006). Life stress and the long-term treatment course of recurrent depression. Non-severe life events predict recurrence for medicated patients over 3 years. Journal of Consulting and Clinical Psychology, 74, 112–120.
  • Muscatell K. A., Slavich G. M., Monroe S. M., & Gotlib I. H. (2009). Stressful life events, chronic difficulties and symptoms of clinical depression. Journal of Nervous & Mental Disease 197, 154–160. http://dx.doi.org/10.1097/ NMD.0b013e318199f77b
  • Preacher K. J., & Hayes A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Method, 40, 879–891. http://dx.doi. org/10.3758/BRM.40.3.879
  • Ruiz F. J., Langer Herrera A. I., Luciano C., Cangas A. J., & Beltrán I. (2013). Measuring experiential avoidance and psychological inflexibility: The Spanish version of the Acceptance and Action Questionnaire-II. Psicothema, 25, 123–129. http://dx.doi.org/10.7334/psicothema2011.239
  • Segal Z. V., Williams J. M. G., & Teasdale J. D. (2006). Terapia cognitiva de la depresión basada en la consciencia plena. Un nuevo abordaje para la prevención de recaídas [Mindfulness based cognitive therapy for depression: A new approach to preventing relapse]. Bilbao, Spain: Descleé de Brouwer.
  • Shallcross A. J., Troy A. S., Boland M., & Mauss I. B. (2010). Let it be: Accepting negative emotional experiences predicts decreased negative affect and depressive symptoms. Behavior Research and Therapy 48, 921–929. http://dx.doi. org/10.1016/j.brat.2010.05.025
  • Shrout P. E., & Bolger N. (2002). Mediation in experimental and nonexperimental studies: New procedures and recommendations. Psychological Methods, 7, 422–445. http://dx.doi.org/10.1037//1082-989x.7.4.422
  • Singer A. R., & Dobson K. S. (2007). An experimental investigation of the cognitive vulnerability to depression. Behaviour Research Therapy, 45, 563–575. http://dx.doi. org/10.1016/j.brat.2006.05.007
  • Spinhoven P., Elzinga B. M., Hovens J. G. F. M., Roelofs K., van Oppen P., Zitman F. G., … Penninx B. W. J. H. (2011). Positive and negative life events and personality traits in predicting course of depression and anxiety. Acta Psychiatrica Scandinavica, 124, 462–473. http://dx.doi. org/10.1111/j.1600-0447.2011.01753.x
  • Tao M., Li Y., Xie D., Wang Z., Qiu J., Wu W., ... Gao J. (2011). Examining the relationship between lifetime stressful life events and the onset of major depression in Chinese women. Journal of Affective Disorders, 135, 95–99. http://dx.doi.org/10.1016/j.jad.2011.06.054
  • Trew J. L. (2011). Exploring the roles of approach and avoidance in depression: An integrative model. Clinical Psychology Review, 31, 1156–1168. http://dx.doi. org/10.1016/j.cpr.2011.07.007
  • Ware J. E. Jr., Snow K. K., Kosinski M., & Gandek B. (1993). SF-36 Health Survey: Manual and interpretation guide. Boston, MA: New England Medical Center.
  • Wells A. (2009). Metacognitive therapy for anxiety and depression. New York, NY: Guilford.
  • Zimmerman M., McGlinchery J. B., Posternak M. A., Friedman M., Attiullah N., & Boerescu D. (2006). How should remission from depression be defined? The depressed patient´s perspective. American Journal of Psychiatry, 163, 148–150.
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